Cancer is a disease that can impact any person, at any age anywhere in the world. In 2018 alone 18.1 million new cases are estimated to have developed, killing around 9.6 million people globally. The disease is, however, far from an equal-opportunity killer: Apart from disproportionately affecting and killing people that smoke, use alcohol or have a poor diet, cancer also disproportionately kills people in low-and middle-income countries, including those of the WHO South-East Asia Region.
Inadequate access to cancer screening, diagnosis and treatment is the primary cause. In 2017, for example, just 30% of low-income countries reported having appropriate cancer treatment services available. That compares to more than 90% of high-income countries. Broadening this chasm is the fact that just 26% of low-income countries reported having pathology services generally available in the public sector, leading to late diagnosis and a lower chance of sending the disease into remission.
Countries across the WHO South-East Asia Region have taken action. As early as 2015 the Regional Committee adopted a resolution on the way forward for cancer prevention and control. The resolution explicitly recognizes the need to develop and strengthen national programmes to this end. That commitment was strengthened in 2017, when the World Health Assembly adopted a resolution emphasizing the need to take an integrated approach to providing cancer services, and when in 2018 the WHO Global Initiative for Childhood Cancer was launched. The Initiative aims to achieve a 60% survival rate for children with cancer by 2030, thereby saving an additional one million lives.
To accelerate progress and counter the fact that more than 67% of the Region’s cancer patients die before the age of 70, several core initiatives must be fortified. Moreover, as the theme of this year’s World Cancer Day – ‘I am and I will’ – emphasizes, each of us must embrace our ability to reduce cancer’s impact on our own lives, the people we love and the world around us. In short, we must take responsibility and act.
Of pressing need is integrating national cancer control programmes into the health system at every level. While cutting-edge tertiary services are important, they are expensive and generally most effective when a cancer is detected early. To make that happen, effective cancer detection and screening services must be available at both secondary and primary facilities. In addition, health workers must be trained to identify the signs and symptoms that could lead to a positive diagnosis, thereby facilitating prompt and successful treatment.
Member States Region-wide should also continue to implement policies that prioritize cancer prevention across sectors. That could mean pursuing the plain-packaging of tobacco products (tobacco is the single largest cause of cancer, making up around 22% of cancer deaths), better regulating alcohol consumption or promoting the virtues of a healthy diet. It could also mean strengthening immunization programmes to ensure every person receives the hepatitis B vaccine and all females receive the human papilloma virus vaccine. Both are powerful aids in the prevention of a range of cancers.
Importantly, each of us can be agents of change and reduce the impact cancer has, both in our own lives and those of others. By avoiding behaviors that are linked to cancer we can reduce our own risk, at the same time as encouraging our peers to do the same. Notably, we can also promote high-level engagement and funding of national cancer prevention and control programmes. As a 2014 World Health Assembly resolution urges, beyond key prevention and control initiatives, this should include promoting the provision of quality palliative services able to give terminal patients the care and dignity they deserve.
WHO is committed to working with Member States to strengthen cancer prevention and control programmes and ensure the tools to prevent, detect and treat cancer are available to all people in the Region. Doing so is commensurate with the Region’s Flagship Priorities on tackling noncommunicable diseases, as well as achieving universal health coverage. It is also commensurate with the conviction that people in low- and middle-income countries should be at no greater risk of cancer and associated mortality than those anywhere else in the world.